Provider Demographics
NPI:1396129474
Name:FAMILY FIRST CHIROPRACTIC CARE
Entity type:Organization
Organization Name:FAMILY FIRST CHIROPRACTIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLATZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-915-8187
Mailing Address - Street 1:16231 W 14 MILE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-3323
Mailing Address - Country:US
Mailing Address - Phone:248-480-0357
Mailing Address - Fax:248-480-0361
Practice Address - Street 1:16231 W 14 MILE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BEVERLY HILLS
Practice Address - State:MI
Practice Address - Zip Code:48025-3323
Practice Address - Country:US
Practice Address - Phone:248-480-0357
Practice Address - Fax:248-480-0361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010256111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty